Eligibility and Transition policy

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Gavi supports the world's poorest countries. The Eligibility & Transition policy sets out the criteria that determine which countries are eligible to apply for different forms of Gavi support.

Eligibility for Gavi support is determined by a country’s Gross National Income (GNI) per capita according to World Bank data. The scale and nature of Gavi’s support changes as GNI per capita increases over time (see figure below). From the beginning of Gavi support, governments are expected to co-finance vaccines by financing a fraction of the needed doses. Gradually, as national income levels grow, co-financing levels for governments increase, per the co-financing policy.

Once countries have surpassed Gavi’s eligibility threshold, they enter an accelerated transition process and start phasing out of Gavi support. During this period, Gavi will intensify its efforts to help transitioning countries be in a good position to financially sustain their immunisation programmes and new vaccines.

Gavi Eligibility and Transition policy 

What is the purpose of Gavi’s Eligibility and Transition policy?

This policy sets out the eligibility criteria – and related terms, processes, and procedures – which Gavi uses to determine which countries can apply for different types of support as they transition along a continuum of economic development to the point that all Gavi support ends. It also describes the characteristics of each phase of Gavi support and the requirements for accessing support for certain vaccines and health systems strengthening support.

How does the policy work?

Countries whose average Gross National Income (GNI) per capita over the past three years is equal to or below Gavi’s threshold are eligible for support. Gavi updates the eligibility threshold annually to take into account inflation adjustments, and updates the list of eligible countries based on the adjusted threshold and the latest World Bank GNI per capita figures. The policy also sets out minimum immunisation coverage requirements for New Vaccine Support.

Countries whose average GNI per capita over the past three years falls below the threshold are classified as either initial self-financing (GNI per capita under the World Bank’s Low-Income Country threshold) or in preparatory transition (above the World Bank’s Low-Income Country threshold). These countries are eligible to apply for New Vaccine or Health System and Immunisation Strengthening Support from Gavi. When a country’s average GNI per capita over the past three years exceeds the threshold, it will enter accelerated transition. The co-financing policy further details the co-financing requirements for countries in each phase.

If, in the future, a country's 3-year average GNI per capita falls below the eligibility threshold, the country would regain its Gavi-eligible status. Under specific circumstances, countries might remain in preparatory transition for an additional two years even after crossing the eligibility threshold.

After five years in the accelerated transition phase, a country becomes fully self-financing. Fully self-financing countries no longer receive Gavi support, but several manufacturers have made commitments to continue providing these countries with access to prices similar to those Gavi pays, for five years after the end of Gavi support.

When was the current policy approved and when will it be updated?

The current eligibility and transition policy was approved on 11 June 2015, and came into effect on 1 July 2015. It replaces the Gavi Eligibility policy as approved by the Board on 18 November 2009 and the Gavi Graduation policy as approved by the Board in 18 November 2009. The policy will be updated as and when required.

US$ 1 = US$ 18

A study in Health Affairs covering 73 Gavi-supported countries over the 2011–2020 period shows that, for every US$ 1 spent on immunisation, US$ 18 are saved in healthcare costs, lost wages and lost productivity due to illness. If we take into account the broader benefits of people living longer, healthier lives, the return on investment rises to US$ 48 per US$ 1 spent.

Ozawa S, Clark S, Portnoy A et al. Return on investment from childhood immunizations in low- and middle-income countries, 2011-20, Health Affairs 2016

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